Exploring differences in hospital treatment among psychiatric inpatients in short-term general hospitals : applications of multi-nominal logistic regression analyses

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Since the creation of Medicaid in 1965 and the massive deinstitutionalization of psychiatric patients, a dramatic increase appeared in the number of psychiatric inpatients in general hospitals. Yet, the population remained hardly examined. The goal of this dissertation study was to identify demographics of psychiatric inpatients with serious mental illnesses in general hospitals and access to hospital treatment and health insurance coverage. The goals of the study were achieved by examining demographics of discharged inpatients diagnosed with schizophrenia spectrum and other psychotic disorders and bipolar and major depressive disorders in general hospitals. Study results showed that sex and age were significant predictors of differences in hospital discharge status between psychiatric inpatients in general hospitals. Men were more likely to be transferred than women to nursing homes and acute psychiatric hospitals. The less common transfer of women to post discharge facilities is speculated to be due to social skills that women patients utilize to build social support networks that facilitate reintegration into their communities. Results of multinomial regression analyses also showed that hospital ownership, hospital's geographic region, and health insurance coverage used by patients were significant predictors of differences between patients' cumulative days of care in general hospitals. Results can inform policy makers, hospital administrators, and clinicians about admission and discharge planning design to reduce days of care psychiatric patients spend in hospitals, and provide informed practice and policy recommendations to facilitate a more equitable and equal access to treatment for diverse psychiatric patient populations.Includes bibliographical references